Random Flashcards
how to calculate anion gap
what is normal range for anion gap
Na - (Cl + HCO3)
8-12 is normal
> 12 (high anion gap)
causes of high anion gap metabolic acidosis
M: methanol U: uremia D: DKA P: propylene glycol I: iron tablets or INH L: lactic acidosis E: ethylene glycol S: salicylates (aspirin)
causes of normal anion gap metabolic acidosis
H: hyperchloremia A: Addison disease R: renal tubular acidosis D: diarrhea A: acetazolamide S: spironolactone S: saline infusion
what is distal renal tubular acidosis type 1
inability of alpha-intercalated cells to secrete H+ –> no new HCO3- is generated –> metabolic acidosis
what is proximal renal tubular acidosis type 2
defect in PCT HCO3- reabsorption –> increased excretion of HCO3- in the urine –> metabolic acidosis
what is hyperkalemic tubular acidosis (type 4)
hypoaldosteronism or aldosterone resistance –> hyperkalemia –> decreased NH3 synthesis in PCT –> decreased NH4+ excretion –> metabolic acidosis
what acid base disturbance can amphotericin B cause
distal renal tubular acidosis type 1
RBC casts in urine indicates
glomerulonephritis, hypertensive emergency
WBC casts in urine indicates
tubulointerstitial inflammation
acute pyelonephritis
transplant rejection
granular casts in urine indicates
acute tubular necrosis (can be “muddy brown”)
fatty casts in urine indicates
nephrotic syndrome (associated with “Maltese cross” sign)
waxy casts in urine indicates
end stage renal disease/chronic kidney disease
1st aortic arch derivative
part of maxillary artery
2nd aortic arch derivative
stapedial artery and hyoid artery
3rd aortic arch derivative
common carotid artery and proximal part of internal carotid artery
4th aortic arch derivative
left: aortic arch
right: proximal part of right subclavian artery
6th aortic arch derivative
proximal part of pulmonary arteries and on LEFT ONLY: ductus arteriosus
1st pharyngeal cleft derivative
external auditory meatus
1st pharyngeal arch derivatives
Cartilage: Maxillary process (Maxilla, zygoMatic bone), Mandibular process (Meckel cartilage, Mandible), Malleus and incus, sphenoMandibular ligament
Muscle:
Muscles of Mastication (temporalis, Masseter, lateral and Medial pterygoids, Mylohyoid, anterior 2/3 tongue)
Nerves:
V3
2nd pharyngeal arch derivatives
Cartilage:
Stapes, Styloid process, leSSer horn of hyoid, Stylohyoid ligament
Muscles:
muscles of facial expression, Stapedius, Stylohyoid, platySma
Nerves:
VII (Smile)
3rd pharyngeal arch derivatives
Cartilage:
greater horn of hyoid
Muscles:
stylopharyngeus
Nerves:
IX
4th and 6th pharyngeal arch derivatives
Cartilage:
Arytenoids, cricoid, Corniculate, Cuneiform, Thyroid
Muscles:
4th - pharyngeal constrictors, cricothyroid, elevator veil palatini
6th - all intrinsic muscles of larynx except cricothyroid
Nerves:
4th - X (superior laryngeal branch)
6th - X (recurrent/inferior laryngeal branch)
1st pharyngeal pouch derivatives
middle ear cavity, Eustachian tube, mastoid air cells
2nd pharyngeal pouch derivates
epithelial lining of palatine tonsil
3rd pharyngeal pouch derivates
inferior parathyroids and thymus
4th pharyngeal pouch derivates
superior parathyroids and parafollicular C cells of thyroid
describe causes of cleft lip and cleft palate
cleft lip: failure of fusion of maxillary and merged medial nasal processes
cleft palate: failure of fusion of two lateral palatine shelves OR failure of fusion of lateral palatine shelf with nasal septum
pathology of primary sclerosing cholangitis
unknown cause of concentric “onion skin” bile duct fibrosis –> alternating strictures and dilation with “beading” of intra- and extra-hepatic bile ducts on ERCP
demographic for primary sclerosing cholangitis
middle aged men with ulcerative colitis
markers/associations in primary sclerosing cholangitis
p-ANCA
increased IgM
pathology of primary biliary cholangitis
autoimmune reaction –> lymphocytic infiltrate +/- granulomas –> destruction of lobular bile ducts
demographic primary biliary cholangitis
middle aged woman
markers/associations for primary biliary cholangitis
anti-mitochondrial antibody
increased IgM
associated with other autoimmune diseases
pathology of secondary biliary cirrhosis
extra hepatic biliary obstruction –> increases pressure in intrahepatic ducts –> injury/fibrosis and bile stasis
demographic secondary biliary cirrhosis
patients with known obstructive lesions (gallstones, biliary strictures, pancreatic CA)
what forms from the fetal cardinal veins
systemic venous circulation (SVC)
do osteoblasts express alk phos
yep
cause of Dublin Johnson syndrome
defective hepatic excretion of bilirubin glucuronides due to mutation in canalicular membrane transport protein
symptoms of rabies
severe, painful throat spasms when eating or drinking
mydriasis and neck rigidity
acting strangely with hallucinations
excessive drooling
what is the BMI cutoff for anorexia
17.5
what antibodies are associated with polymyositis
anti-Jo-1 (anti-histidyl-tRNA synthetase)
anti-SRP
anti-Mi-2 (anti-helicase)
how does prostacyclin affect platelet aggregation
inhibits platelet aggregation and adhesion to the vascular endothelium
what are the steps of base excision repair
glycosylase –> endonuclease –> lyase –> polymerase –> ligase
what cytokine is related to giant cell arteritis
IL-6
what is found in the stool in a strongyloides stercoralis infection
rhabditiform larvae
compare symptoms of immediate and acute hemolytic transfusion reactions
immediate: anaphylaxis, IgE-mediated
acute: urine becomes brown, antibody-mediated (type II HSR)
what genetic expression is associated with mitochondrial disorders
heteroplasmy
